Adult Dosing

Urinary retention

• Start 5-10 mg PO q1 hr until response, up to 50 mg
• Range: 10-50 mg PO tid-qid

Neurogenic bladder

• Start 5-10 mg PO q1 hr until response, up to 50 mg
• Range: 10-50 mg PO tid-qid

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

Urinary retention (Not FDA approved)

• 0.6 mg/kg/day PO divided tid-qid
• Note: Give on empty stomach 1 hr before or 2 hrs after meal

[Outline]

• Adult Dosing
• Pediatric Dosing

• Postpartum and postoperative nonobstructive urinary retention
• Urinary retention caused by neurogenic bladder

• Hypersensitivity
• Hyperthyroidism
• Peptic ulcer disease
• Asthma
• Hypotension, severe
• Bradycardia, severe
• Bladder neck obstruction
• Bladder surgery
• Recent GI obstruction
• Recent GI disturbances
• GI resection and anastomosis
• Spastic GI lesions
• Acute inflammatory lesions of the GI tract
• Peritonitis
• Vagotonia, severe
• Vasomotor instability
• CAD
• Seizure disorder
• Parkinson's dz

Renal Dose Adjustment

• Dose adjustment not defined

Hepatic Dose Adjustment

• Dose adjustment not defined

• Bethanechol should be taken 1-2 hrs before meals to avoid nausea or vomiting
• Advise patients to notify health care provider if urinary retention persists
• Monitor BP and pulse and voiding patterns
• Reflux infection may occur if urinary sphincter doesnot relax and urine is forced back into renal pelvis

Pregnancy Category:C

Breastfeeding: No information available regarding use of bethanechol during breastfeeding. If used during breastfeeding, monitor the infant for signs/symptoms of cholinergic excess (diarrhea, lacrimation, and excessive salivation or urination). This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 7 May 2010).

• CV: Hypotension with reflex tachycardia, vasomotor response
• GI: Abdominal cramps or discomfort, diarrhea, nausea, colicky pain, salivation, borborygmi
• DERM: Flushing, sweating
• RESP: Asthmatic attacks, bronchospasm
• CNS: Headache, seizures
• GU: Urinary urgency
• EENT: Lacrimation, miosis
• MISC: Malaise

• Mechanism of action: Bethanechol is a synthetic ester which is structurally and pharmacologically related to acetylcholine. Selectively stimulates muscarinic cholinergic receptors with no affect on nicotinic receptors; effects contraction of urinary bladder, increases detrusor muscle tone and GI motility
• Poorly absorbed following oral administration
• Metabolism: Unknown
• Excretion: Unknown
• Half-Life: Unknown

US Trade Name(s)

• Duvoid
• Urecholine

US Availability

bethanechol (generic)

• TABS: 5, 10, 25, 50 mg

Duvoid

• TABS: 10, 25, 50 mg

Urecholine

• TABS: 5, 10, 25, 50 mg

Canadian Trade Name(s)

• Duvoid
• Myotonachol

Canadian Availability

bethanechol (generic)

• TABS: 10, 25, 50 mg

Duvoid

• TABS: 10, 25, 50 mg

Myotonachol

• TABS: 10, 25 mg

UK Trade Name(s)

• Myotonine

UK Availability

Myotonine

• TABS: 10, 25 mg

Australian Trade Name(s)

• Urocarb

Australian Availability

Urocarb

• TABS: 10 mg

[Outline]

Urologic

Genitourinary Tract Agents;Miscellaneous

Pricing data from www.DrugStore.com in U.S.A.

• Urecholine 50 MG TABS [Bottle] (TEVA/WOMENS HEALTH)
  90 mg = $381.84
  270 mg = $1123.68
• Urecholine 10 MG TABS [Bottle] (ODYSSEY PHARMACEUTICALS INC.)
  90 mg = $119.99
  270 mg = $335.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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